Free TC-301, Utah Bonded Motor Vehicle Business Application - Utah

Utah State Tax Commission

TC-301
Rev. 7/09

Bonded Motor Vehicle Business Application

Dealer number: ____________ _ _ _ _ _ _

Complete entire form and return it to the Motor Vehicle Enforcement Division at: 210 North 1950 West, Salt Lake City, UT 84134. Telephone: (801) 297-2600
Business organization Sole proprietorship Partnership Corporation
Business name Principal place of business street address City Mailing address (if different from street address) City

Application date: ____________ _ _ _ _ _ _ Sales tax number: __________ _ _ _ _ _ _ _

LLC LLP S-Corp

Entity change

License type New motor vehicle and/or new large trailer dealer ($127) Used motor vehicle and/or used large trailer dealer ($127) Additional location ($26 each)
Telephone number

New motorcycle and/or new small trailer dealer ($51) Used motorcycle and/or used small trailer dealer ($51)

State

ZIP Code State ZIP Code

Address of additional Utah locations of this business (attach additional sheet(s) if necessary) ($26 fee for each location)
Street address City Street address City ZIP Code ZIP Code Lot # Lot # Street address City Street address City ZIP Code ZIP Code Lot # Lot #

Owner(s), partner(s) or corporate officers information (attach additional sheet(s) if necessary)
Name Home address City Hair color Eye color State Height Title Social Security Number ZIP Code Weight Home phone Driver's license number and state Date of birth Gender Male Female

Under state and federal law we cannot issue a license to any person who does not provide this information. Check one: I am a U.S. citizen. SSN: _______________ _ _ _ _ _ _ _ _ I-94# or SSN: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Alien #: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ The Alien Registration Number (A#) and the I-94 (arrival/departure) number are issued by the U.S. Citizenship and Immigration Service.

I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully.

Page 1 of 3

TC-301, page 2 of 3
Name Home address City Hair color Eye color State Height Title Social Security Number ZIP Code Weight Home phone Driver's license number and state Date of birth Gender Male Female

Under state and federal law we cannot issue a license to any person who does not provide this information. Check one: I am a U.S. citizen. SSN: _______________ _ _ _ _ _ _ _ _ I-94# or SSN: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Alien #: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ The Alien Registration Number (A#) and the I-94 (arrival/departure) number are issued by the U.S. Citizenship and Immigration Service.
Name Home address City Hair color Eye color State Height Title Social Security Number ZIP Code Weight Home phone Driver's license number and state Date of birth Gender Male Female

I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully.

Under state and federal law we cannot issue a license to any person who does not provide this information. Check one: I am a U.S. citizen. SSN: _______________ _ _ _ _ _ _ _ _ I-94# or SSN: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Alien #: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ The Alien Registration Number (A#) and the I-94 (arrival/departure) number are issued by the U.S. Citizenship and Immigration Service.

I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully.

Franchise Dealers
If you are a franchise dealer of new vehicles, RVs, motorcycles and/or trailers, report the information below and attach your franchise agreement to this application
Make Address of manufacturer or distributor Make Address of manufacturer or distributor Make Address of manufacturer or distributor Make Address of manufacturer or distributor Name of manufacturer or distributor Name of manufacturer or distributor Name of manufacturer or distributor Name of manufacturer or distributor

TC-301, page 3 of 3
1. Has anyone connected with the ownership or management of the dealership ever been the holder of a motor vehicle salesperson, dealer, dismantler or auction license? Yes No

_ _ _ _ If yes, give business name and indicate which owner: ______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2. Has the above license ever been denied, suspended or revoked? Yes No

If yes, give details and indicate which owner:_ _ _______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. During the past 10 years, have you been convicted of any misdemeanors or felonies in Utah or any other state, or do you have any pending charges awaiting judicial action or review? Yes No Failure to disclose any of the requested information may result in suspension of this license. A criminal conviction for a motor vehicle or drug-related crime, fraud or registered sex offense can be grounds for denial.

If yes, list each conviction and indicate which owner: _______________________________ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ ________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

4. Are you currently on probation or parole? Yes No

If yes, which owner? _______________________________________________

Signature
I am familiar with the motor vehicle dealer licensing law and other laws of Utah governing the conduct of motor vehicle salespersons and will cooperate with the Utah State Tax Commission to eliminate abuse and unfair trade practices. I do solemnly swear (or affirm) that the statements contained in this application are true and correct and that I, as owner, as a member of the partnership, or as an officer of the corporation, have authority to sign this application and to make the statements set forth herein. ____________________________
Firm name

____________________________
Signature or owner, partner or corporate officer*

____________________________
Printed name of signer * The signer must be owner, partner or corporate officer, or have POA. Submit copy of POA if applicable.